What are the Experiencs of Registered Nurses working in Residential Aged care Facilities

Aim: To explore the experiences of registered nurses working in residential aged are facilities in Australia. Background: The number of aged care residents with high acuity and complex care needs in aged care facilities is steadily increasing. However, despite the Aged Care Royal Commission’s recent mandated staffing determination, the number of registered nurses employed in aged care has declined. Instead, non-qualified care workers now make up 70% of the aged care workforce. This shift, coupled with organisational challenges such as inadequate education, inappropriate skill mix, and suboptimal registered nurse to resident ratios, has negatively impacted the ability of registered nurses to deliver high-quality care. Additionally, attracting qualified nurses to specialise in gerontological care in residential aged care facilities remains a persistent challenge due to the sector’s low-status, poor renumeration, and lack of career advancement opportunities. Research Design: This study employed a qualitative narrative inquiry methodology to explore the experiences of registered nurses working in residential aged care facilities in Australia. Data were collected through semi-structured interviews with eight registered nurses from around Australia who had worked in residential aged care facilities with at least 12 months of experience in the setting. The interviews were transcribed verbatim and analysed using Braun and Clarke’s six-step guide to thematic analysis. These themes were then interpreted through the lens of Clandinin and Connelly’s three-dimensional framework, focussing on the interconnected concepts of temporality, sociality, and place. Findings: The findings identified three major themes and eight subthemes and highlighted how work intensification impacted on delivery of care to older residents in aged care. The major themes identified included staff shortages, lack of education and training, and compromising care. The findings highlighted the challenges registered nurses faced due to the many constraints placed upon them working in residential aged care including, paperwork and documentation, compromising care, inadequate staffing, lack of support and lack of education and training. Conclusion: Registered nurses working in residential aged care facilities experienced many challenges related to working in the sector including a lack of support, conflicting roles and demands, inadequate staffing, and a lack of time in maintaining relationships, and providing quality care. Recommendations to support registered nurses included designing clear career pathways, increasing the education and training by having an educator on site, and collaborating with stakeholders and universities to foster partnerships that align curricula with industry needs and strengthen support networks for nurse graduates entering the aged care workforce.